Therapy plays a key role in an addiction rehab program. Through therapy, you have a chance to explore how the addiction developed and how your thoughts, feelings, and beliefs helped to lock that addiction in place. In therapy, you also have an opportunity to pick up new skills and belief systems. Those could give you the strength you need to cope with cravings, challenges, and other bumps on your road to recovery.
When you enroll in rehab, you are likely to spend a great deal of time in therapy, but you might take advantage of many different therapy types each and every day. Those different therapy types can work together, enhancing lessons and helping you to grow. So it makes sense to learn more about the different types of therapy you might get, so you will understand how to get the most out of each session you participate in.
This article contains a comparison of two different therapy programs you might try as you recover: experiential therapy and Cognitive Behavioral Therapy (CBT).
The American Society of Experiential Therapists explains that this form of therapy helps people to process the past, understand the present, and plan for the future. In other words, this is a form of therapy that is designed to help people dive deep into the experiences that have shaped their drug addiction. But unlike other forms of therapy that might rely only on talk, experiential therapy relies on doing something. During these sessions, people might be doing something that they consider fun or at least a little diversionary.
The American Psychological Association builds on this definition by stating that people who participate in this therapy are considered experts of their own past, present, and future experiences. The therapy is designed to help people take ownership of that expertise, so they can take a leadership role in their own lives. As a result, a secondary goal of this therapy is to build a sense of empowerment. People who participate in these sessions should walk away with an enhanced sense of power and voice. They should feel slightly more able to handle challenges and interpret those challenges, due to the lessons learned in therapy.
CBT Mayo Clinic reports that CBT is designed to uncover the thoughts that stand behind a person’s decisions. In these sessions, people learn to tap into the workings of the subconscious, so they can learn to control their impulses before they make decisions that could jeopardize their long-term health and happiness.
Once people can identify those thoughts, the therapy takes a secondary shift. In later sessions, people learn how to change their thought patterns, so they can resolve difficult feelings without ever acting upon them.
The overarching goal is to change behavior. But that behavior shift, in CBT, comes about due to understanding thought processes and resolving difficult thoughts.
Experiential therapy is designed to help a person learn by doing. Some therapists use role-play in their experiential therapy sessions. They take on the role of a parent or a partner, and the therapist and the person hold a long discussion with breaks for contemplation and learning. Other experiential therapists use art, music, or animals to help people explore difficult or hidden issues they have never been able to deal with in the past.
In most of these sessions, the focus is on doing something. The unconscious is working, but the person’s higher thought processes are focused on making something happen or making something work. In the midst of those sessions, counselors break the action to help the person to interpret what is happening.
Some counselors use simple questions to accomplish that task. But as an article in the Journal of Psychotherapy Integration points out, therapists who use this approach are careful not to doubt the veracity of the person’s experience. The person’s opinions about the self and the person’s experience are always respected. The goal is not to challenge the person’s ideas, but to help those ideas to take shape.
CBT is much more structured than experiential therapy. People who employ this form of therapy are expected to follow a very specific set of steps, in order to ensure that they are applying the right form of therapy at the right time. Typically, sessions begin with a discussion of a difficult moment the person experienced in the day or week prior. The person explains what happened, and the therapist asks questions that are designed to challenge the person’s thought processes that shaped the event.
For example, if the person walks into therapy believing that a party went wrong the night before because everyone was laughing at that person, the counselor could ask, “Are you sure they were laughing at you? How could you tell? What did you do to test that theory? Is it possible they were laughing at someone or something else? How would you test that theory?”
CBT sessions involve quite a bit of minute discussion, back and forth between a client and the counselor. A great deal can be accomplished, and as a result, there are often few sessions offered. In fact, the National Association of Cognitive-Behavioral Therapists suggests that the average person gets just 16 CBT sessions. It is reasonable to assume then that the average CBT program moves quite quickly. There is little time for dalliance or sloth. People have work to get done, and they must get it done fast.
Since experiential therapy relies on a sense of openness and play, and since people who participate are asked to take charge of their own emotions and opinions, it is a therapy that is best for committed people who are willing to work with a therapist on issues that are hard to discuss openly. People who feel forced into therapy, and who refuse to talk openly with a professional, might not succeed in this form of therapy. But those who walk into sessions with an open mind are well suited to learn.
CBT is made for all sorts of different people from all sorts of different backgrounds. CBT practitioners are adept at helping even reluctant people come to terms with the lessons they need to learn from the therapy. But there is a great deal of work involved with CBT, and much of that work takes place outside of the counseling center.
The Anxiety and Depression Association of America says that people are expected to read, keep records, and complete homework assignments between treatment sessions. All of these steps take time, and none of them are optional. Those who have tight schedules and a lack of willingness to work on the issue in off hours are not best for this form of therapy.
There are some studies that suggest that experiential therapy has the ability to help people to heal. For example, in a study in the journal Society and Animals, researchers tracked people for six months after they completed equine-assisted experiential therapy, and they found big benefits in terms of psychological distress and psychological wellbeing. Studies like this seem to suggest that people can benefit from the experiential approach.
But since there are so many forms of experiential therapy, and since this form of therapy can be applied to so many different types of problems, it is difficult to accurately prove how well it works in controlled environments. Studies are ongoing, and there may come a day when there is a definitive body of research that proves the approaches work, but that day has not yet come.
CBT is a very old form of therapy, and it has been extensively studied. According to the National Alliance on Mental Illness, CBT has a considerable amount of research that proves its efficacy. It has been proven effective as a treatment for:
- Bipolar disorder
- Eating disorders
Some studies even suggest that CBT can change the chemistry of the brain, changing how people think and react on a cellular level.
People who prefer to use therapy approaches that have been proven effective with scientific studies may benefit from CBT.
Which Is Best?
Knowing how therapy works can be important for people working on addiction recovery, but people do not need to be therapy experts in order to benefit. Counselors can help to guide the therapy process, selecting the approaches that seem right for the clients in their care. People may be able to weigh in on those selections, and they might be able to stop using approaches they do not think are right for them. But they do not need to choose based on the therapy approaches they have read about. Instead, they can simply head to therapy with an open heart, and let the therapist be the guide.
If you are living with an addiction, the most important thing is for you to get therapy. Just get started. You will be amazed at what you can learn and how you can grow.